Now revised and expanded with 50% new content reflecting important clinical refinements, this manual presents a widely used evidence-based therapy approach for adult survivors of chronic trauma. Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy helps clients to build crucial social and emotional resources for living in the present and to break the hold of traumatic memories. Highly clinician friendly, the book provides everything needed to implement STAIR—including 68 reproducible handouts and session plans—and explains the approach's theoretical and empirical bases. The large-size format facilitates photocopying; purchasers also get access to a Web page where they can download and print the reproducible materials. First edition title: Treating Survivors of Childhood Abuse: Psychotherapy for the Interrupted Life.
New to This Edition
• Reorganized, simplified sessions make implementation easier.
• Additional session on emotion regulation, with a focus on body-based strategies.
• Sessions on self-compassion and on intimacy and closeness in relationships.
• Chapter on emerging applications, such as group and adolescent STAIR, and clinical contexts, such as primary care and telemental health.
• Many new or revised handouts—now downloadable.
• Updated for DSM-5 and ICD-11.
“The book presents a solid theoretical foundation on which the authors have built a detailed plan of action to guide the therapist and, perhaps just as important, inform the client....The treatment sequence itself is brilliantly conceived.”
—PsycCRITIQUES (on the first edition)
“This is a wonderful book….Though trauma work is difficult, this book provides a coherent rationale and treatment program.”
—Doody's Electronic Review (on the first edition)
“The second edition of this amazing resource builds on and expands the first edition. It conveys a deep understanding of survivors of abuse and presents a treatment model that flexibly addresses their varied needs. The book contains practical discussion and application and includes a wealth of handouts. STAIR Narrative Therapy fulfills the criteria for an evidence-based treatment, as it is built on theory, research findings, clinical observation, and client preferences. STAIR is a fitting acronym—the book presents a set of skills in a developmental and progressive sequence, one step at a time.”
—Christine A. Courtois, PhD, ABPP, private practice (retired), Washington, DC; consultant and trainer, trauma psychology and treatment
“For therapists who want a clear, structured way to help trauma clients increase their coping skills and revise the narrative of their traumatic experiences, this book is a gem. The session outlines and client exercises are systematic and amazingly thorough. I particularly appreciate the book's respectful stance toward the client, the down-to-earth focus on emotion, and the accessible way topics such as complex trauma are laid out. This second edition is a great contribution to the literature. It will be particularly helpful to mental health professionals who are beginning the journey into treating the chaos of trauma with their clients.”
—Susan M. Johnson, EdD, Professor Emeritus of Clinical Psychology, University of Ottawa, Canada; Distinguished Research Professor, Marital and Family Therapy Program, Alliant International University, San Diego
“Cloitre and colleagues have done a fabulous job updating and expanding their book on STAIR Narrative Therapy for childhood abuse and chronic interpersonal trauma. STAIR is now strongly supported by the authors' own research, as well as being grounded in the broader trauma research literature. The book offers a carefully delineated description of this brief yet comprehensive treatment. The step-by-step explanations and numerous downloadable handouts make this book an excellent learning tool for beginning therapists—it also has plenty to offer seasoned therapists. Highly recommended.”
—Catherine C. Classen, PhD, Department of Psychiatry, University of California, San Francisco
“The authors' theoretical and clinical model of early trauma and adversity leading to an interrupted life is a very helpful perspective to understand this important clinical group. This book provides a detailed treatment manual on how to conduct STAIR Narrative Therapy. Therapists will hugely benefit from the many case examples, handouts, and step-by-step instructions. A new chapter in the second edition describes adaptations of STAIR for specific populations and settings, showing that the authors constantly work on refining and developing their evidence-based approach.”
—Thomas Ehring, PhD, Department of Psychology, Ludwig-Maximilians-Universität Munich, Germany
“This second edition leaves no stone unturned. It is an invaluable resource for both experienced clinicians and the next generation of therapists, who will gain a precise and systematic method for helping their clients with childhood trauma. This book uncovers the troubling complexities of trauma while presenting a promising path forward through STAIR Narrative Therapy.”
—David M. Greenberg, PhD, Zuckerman Postdoctoral Scholar, Bar-Ilan University, Israel; Visiting Researcher, Department of Psychiatry, University of Cambridge, United Kingdom
Table of Contents:
I. Theoretical Frameworks
1. A Resource Loss Model [ pdf sample courtesy of Guilford ]
2. Attachment: When Protector and Perpetrator Are One
3. Development in the Context of Deprivation
II. Foundations of Treatment
4. Treatment Rationale
5. Building Emotional and Social Resources: Overview of STAIR
6. Working with Traumatic Memories: Overview of Narrative Therapy
7. Extending the Narrative: Transforming Shame and Loss
8. Guidelines for Implementing Treatment
9. Assessment of Client and Match for Treatment
III. STAIR Narrative Therapy, Session by Session
- Module I. Skills Training in Affective and Interpersonal Regulation (STAIR): Building Resources
10. Session 1. The Resource of Hope: Introducing the Client to Treatment
11. Session 2. The Resource of Feeling: Emotional Awareness
12. Session 3. Emotion Regulation: Focus on the Body
13. Session 4. Emotion Regulation: Focus on Thoughts and Behavior
14. Session 5. Emotionally Engaged Living: Distress Tolerance
15. Session 6. The Resource of Connection: Understanding Relationship Patterns
16. Session 7. Changing Relationship Patterns: Focus on Assertiveness
17. Session 8. Changing Relationship Patterns: Managing Power
18. Session 9. Changing Relationship Patterns: Increasing Closeness
19. Session 10. Self-Compassion and Summary of Skills Training
- Module II. Narrative Therapy: Facing the Past and Imagining the Future
20. Moving from Skills Training to Narrative Therapy: How Do You Know Your Client Is Ready?
21. Session 11. Introduction to Narrative Therapy
22. Session 12. Narrative of First Memory
23. Sessions 13–17. Narratives of Fear
24. Sessions 13–17. Narratives of Shame
25. Sessions 13–17. Narratives of Loss
26. Session 18. The Final Session
27. New Developments for STAIR Narrative Therapy
About the Authors:
Marylene Cloitre, PhD, is Associate Director of Research in the National Center for PTSD Dissemination and Training Division, Palo Alto VA Health Care System; Clinical Professor (Affiliate), Department of Psychiatry and Behavioral Sciences, Stanford University; and Research Professor, Department of Psychiatry, NYU Langone Medical Center. Dr. Cloitre’s primary clinical and research interests are the developmental consequences and treatment of childhood abuse in adults and adolescents. She is the recipient of the Award for Outstanding Contributions to Practice in Trauma Psychologyfrom Division 56 of the American Psychological Association, is past president of the International Society for Traumatic Stress Studies, and was a member of the World Health Organization's ICD-11 working group on trauma spectrum disorders.
Lisa R. Cohen, PhD, has maintained a private practice in clinical psychology in New York City since 2001. Dr. Cohen specializes in the treatment of trauma and stress-related disorders, as well as co-occurring anxiety, mood, eating, and substance use disorders. Previously, she was a Research Scientist at the New York State Psychiatric Institute at Columbia University Medical Center, where she focused on developing, evaluating, and disseminating evidence-based psychotherapies for PTSD and substance use disorders.
Kile M. Ortigo, PhD, is Program Director in the National Center for PTSD Dissemination and Training Division, Palo Alto VA Health Care System. He leads a national initiative to evaluate and implement webSTAIR, an online program based on STAIR. Dr. Ortigo's research and writing have largely focused on personality, trauma, adult attachment, and lifespan developmental models of self. He has a private practice in Palo Alto, California. He serves as the lead editor for Psychedelic Support, an online resource and directory of clinicians.
Christie Jackson, PhD, is Director of Clinical Training for webSTAIR, an online program based on STAIR. Since 2005, Dr. Jackson has maintained a private practice in clinical psychology in New York City. She formerly served as Director of the PTSD Clinics at the Manhattan and Honolulu VA Medical Centers. She has worked with Marylene Cloitre since 2007 on numerous projects to evaluate and disseminate STAIR within the VA and in the community. She currently serves as Lead Trainer for the STAIR Institute.
Karestan C. Koenen, PhD, is Professor of Psychiatric Epidemiology at the Harvard T. H. Chan School of Public Health. She uses a developmental approach to understanding the epidemiology of trauma exposure and stress-related mental disorders such as PTSD and depression. Dr. Koenen is a recipient of the Award for Outstanding Contributions to the Science of Trauma Psychology from Division 56 of the American Psychological Association and the Robert S. Laufer, PhD, Memorial Award for Outstanding Scientific Achievement from the International Society for Traumatic Stress Studies. Dr. Koenen also advocates for survivors of violence and trauma.